Student Name: Mitaliben R.

Gor
Southwestern Oregon Community College Nursing Program
Nursing 110
Foundations of Nursing: Health Promotion

Clinical Evaluation Tool

Nursing 110 Clinical Evaluation Tool Student Name: Mitaliben R. Gor

. Clinical Week
 Make-
1 2 3 4 5 6 7 8 9 up

10/1 10/2 10/2 11/1 11/1

Compete Dates 10/8 11/5 11/26 12/2
ncy (C) 5 2 9 2 9
Course Holid
Outcome Attendance: P=Present, A=Absent, T=Tardy p p p P P p p p
ay
s
(CO)
Flu
Facility/Unit BCV BCV BCV Clini BCV Cafe BCV NA BCV
c
C9 Applies concepts and theory to clinical practice in client na na na s s s s
CO 1, 2 care and written assignments:
1. Collects data and conducts a health assessment on a
na na
client.
2. Analyzes and interprets the data/assessment findings. na na na s s na s na s
3. Prioritizes health problems. na na na s s na s na s
4. Develops a plan of care that considers the individual, na na na s s na s na s
family, age of client, developmental stage, psycho-
socio-cultural issues, and/or learning needs.
5. Evaluates and reflects on plan of care. na na na s s na s na s
C 8, CO Uses therapeutic communication with patients and s s na s na s
agency staf
n/o s n/o
5
C 6,7,8 Recognizes cultural issues and interact with clients in s s na s na s
culturally sensitive ways
n/o n/o n/o
CO 1,4
C10, Uses research and evidence to support clinical decision s s s s s na s s
making
na
CO2
C6, s s s s s na s na s
Utilizes resources as needed
CO2
C9, Demonstrate responsibility and accountability for s s s s s na s na s
CO2 professional behavior:
1. Performs safely in clinical.
C3 2. Prepared for clinical (Appropriate attire, appropriate s s s s s na s na s
tools such as stethoscope, skills list, evaluation tool,
assessment tools).
C4 3. Takes initiative in making decisions and assuming s s s s s na s na s
responsibility for decisions.
C3 4. Looks for opportunities for continued learning and s s s s s na s na s
self-development.
C4 5. Identifies behaviors and attitudes influencing s s s s s na s na s
professional behavior.
C1,2 6. Demonstrates growth in coping with stressful s s s s s na s s
situations in a calm and dependable manner.
na
C1, s s s s s na s na s
7. Maintains patient confidentiality.
CO3
 C3, s ni s s s na s na s
8. Completes and submits assignments on time.
CO8
C2 9. Organizes and manages time efectively. s s s s s na s na s
C4, s s s s s na s na s
10. Attends and participates at post-conference.
CO8
Instructor Initials mjs mjs mjs mjs mjs mjs mjs mjs mjs
Student Initials
Key: C=Competency, CO=Course Outcome
2

The purpose of the weekly clinical performance evaluation tool is to provide feedback about achievement of the course outcomes
and competencies and to assist the student to meet the standards of care for nurses in Oregon as outlined in the Nurse Practice
Act.

Explanation of Rating Scale:

(S) Satisfactory = Clinical performance is safe and student adequately demonstrates application of the nursing process/clinical
judgment, required skills, and expected synthesis of learning appropriate to level in the program. Verified by direct instructor
observation.

(NI) Needs Improvement = Indicates that additional learning and attention to detail is required for a particular item or that the
overall performance for the week is at a minimum level. The instructor will write an explanation of the rating on the comments
page.

(U) Unsatisfactory = Clinical performance is unsafe and inadequately demonstrates application of the nursing process/clinical
judgment model, required skills, and expected synthesis of learning appropriate to level in the program. The instructor will write
an explanation of the rating on the comments page.

(NA) Not applicable = Particular item does not apply to the clinical performance.

(NO) Not observed = Instructor did not observe or has no knowledge of the students performance of the activity.

Students with a grade of NI or U will be required to meet with their advisor and clinical instructor and discuss a plan for change in
their behavior before their next clinical experience.

Safety and legal/ethical concepts are considered critical to the profession and will be graded as NI or U if any violation occurs.

If a student is assigned a U or NI for two weeks, the faculty will review the students clinical performance and consider the
options of either placing the student on probation or dismissing from the program.

In cases of potential failure, notification of the student by the instructor that she/he has been assigned a grade of U or NI for one
week constitutes proper warning of the grade status.
If a student is placed on probation and then receives a grade of U, the faculty will review the students performance and
determine whether or not the student will be dismissed from the program.

Instructor include comments that are positive, areas that need improvement or are Student
Initials
Week unsatisfactory. Reference the course outcomes listed in the syllabus and/or the OCNE
Competencies from the Nursing Student Handbook (Date/Sign all entries)
First clinical experience. Orients to unit and works with classmates. Practices skin assessment MRG
1 and VS. Good communication with staf and
classmates-----------------------------------------------------------------MSperry MSN RNc
Cares for patient and completes thorough health history. Works with classmates and patients to MRG
help with ADLs beds and baths. I did not get your care plan prep paperwork. This must be
2 turned in each week with your evaluation tool
-----------------------------------------------------------------------------------------------------------------------MSperry
MSN Rnc
Improved time management and looks for skills to work on. Be cautious when documenting MRG
your assessment findings, Be clear, concise and objective. Generalized terms and subjective
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data are vagueuse subjective data only when quoting a patient. Work on DAR format charting.
If you are unsure ask me----------------------MSperry MSN RNc
Participates in community flu clinic at Coos Bay Fire Depart. Works with 2nd year nursing MRG
students and EMT students Assesses patrons and does VS as well as vaccine education. When
doing ear assessment be sure to be considerate of your clients comfort, I did see a couple of
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them flinch a bit. Also- please use the manual BP cufs when provided rather than your personal
electronic cuf. Part of the experience is to practice the skill of taking manual VS--------------
MSperry MSN RNc
5 Cares for patient with bilateral knee replacement. Accurately identifies nursing dx of MRG
 constipation. Be sure to use the proper form for your care prep you are missing a column
Practices DAR charting and care planning. Practice being specific and measurable in your goal
and interventions as indicated on care plan. ----------------------MSperry MSN RNc

Community Cafe MRG

6

Has beginning understanding of the nursing process and is starting to bridge her knowledge of MRG
PT into her nursing care. During the next term we will continue that bridge to a full nursing care
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plan. Works well with staf and classmates and is eager to put new skills and knowledge to
work----------------------------------------------------------------MSperry MSN RNc
Thanksgiving Holiday MRG
8

Final clinical experience- beginning to integrate previous knowledge of PT in a nursing care plan MRG
appropriately. Does patient centered care planning we will work on separating medical and
9
therapy interventions and wording from nursing nice start and welcome new little one this
break!-------------------------------------------------Msperry MSN RNc
Clinic
al
Make-
up
9/1/09: rev 05062011: reviewed 9/2014 sw
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